RESUMEN
Musical hallucinations (MH) typically occur among elderly individuals and are associated with hearing impairment. The authors describe a patient with features of typical MH who was successfully treated with donepezil, a cholinesterase inhibitor, as a combination therapy and who has not shown any subsequent cognitive decline for approximately 5 years. The efficacy of donepezil in this patient indicates that age-dependent dysfunction of cholinergic neurons might be related to the development of MH.
Asunto(s)
Alucinaciones/tratamiento farmacológico , Indanos/uso terapéutico , Música/psicología , Nootrópicos/uso terapéutico , Piperidinas/uso terapéutico , Anciano de 80 o más Años , Donepezilo , Quimioterapia Combinada , Femenino , Alucinaciones/psicología , Trastornos de la Audición/complicaciones , HumanosRESUMEN
Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a possible treatment for psychiatric and neurological disorders characterized by focal brain excitability, such as major depression and action myoclonus. However, the mechanism of modulating excitability by rTMS is unclear. We examined the changes in high frequency oscillations (HFOs) of somatosensory evoked potentials (SEPs) before and after slow rTMS over the right primary somatosensory cortex (0.5 Hz, 50 pulses, 80% motor threshold intensity). The HFOs, which represent a localized activity of intracortical inhibitory interneurons, were significantly increased after slow rTMS, while the SEPs were not changed. Our results suggest that slow rTMS affects cortical excitability by modulating the activity of the intracortical inhibitory interneurons beyond the time of the stimulation and that rTMS may have therapeutic effects on such disorders.